A 22﹣year﹣old female patient received methylprednisolone sodium succinate( methyl﹣prednisolone)for injection( 1 000 mg/d for 3 days and gradually reduced to 60 mg/d for maintenance therapy,IV infusion),immunoglobulin( 20 g/d,IV infusion),mouse nerve growth factor( 20 μg/d, intramuscular injection),vitamin B1(100 mg/d,intramuscular injection),and mecobalamin(1 mg/d,IV injection)for multiple sclerosis. Twelve days later,mouse nerve growth factor was temporarily discontinued and 7 days later,the drug was given again. On day 2 of retreatment,the patient developed conjunctival congestion. On day 3 of retreatment,red spots appeared on her chest,back,abdomen,and forearms. Then the rashes gradually increased,linked into pieces,and spread all over the body. Rashes partly formed blisters,blisters ulcerated,and epidermis exfoliated. It was considered that mouse nerve growth factor induced the toxic epidermal necrolysis. Then the drug was discontinued,the dose of methylprednisolone was increased to 500 mg/d,and at the same time,immunoglobulin,desloratadine,and fexofenadine were given. Twenty days later,the rashes subsided and pigmentation remained.

A 22﹣year﹣old female patient received methylprednisolone sodium succinate( methyl﹣prednisolone)for injection( 1 000 mg/d for 3 days and gradually reduced to 60 mg/d for maintenance therapy,IV infusion),immunoglobulin( 20 g/d,IV infusion),mouse nerve growth factor( 20 μg/d, intramuscular injection),vitamin B1(100 mg/d,intramuscular injection),and mecobalamin(1 mg/d,IV injection)for multiple sclerosis. Twelve days later,mouse nerve growth factor was temporarily discontinued and 7 days later,the drug was given again. On day 2 of retreatment,the patient developed conjunctival congestion. On day 3 of retreatment,red spots appeared on her chest,back,abdomen,and forearms. Then the rashes gradually increased,linked into pieces,and spread all over the body. Rashes partly formed blisters,blisters ulcerated,and epidermis exfoliated. It was considered that mouse nerve growth factor induced the toxic epidermal necrolysis. Then the drug was discontinued,the dose of methylprednisolone was increased to 500 mg/d,and at the same time,immunoglobulin,desloratadine,and fexofenadine were given. Twenty days later,the rashes subsided and pigmentation remained.

A 58-year-old male patient received aspirin enteric-coated tablets 200 mg and rosuvastatin calcium 10 mg once daily by mouth,IV infusions of butylphthalide and sodium chloride injection 100 ml (containing butylphthalide 25 mg and sodium chloride 0.9 g)twice daily and troxorutin brain protein hydrolysate 10 ml once daily for acute ischemic stroke. Seven days later,laboratory tests showed blood urea 6.9 mmol/L,serum creatinine (Scr)131 μmol/L,and blood cystatin C 1.54 mg/L. Kidney injury induced by butylphthalide and sodium chloride injection was considered. Butylphthalide and sodium chloride injection was stopped but the other drugs as well as Xueshuantong for injection (注射用血栓通)and Corbrin capsule (百令胶囊)were given. Laboratory tests showed blood urea 6.2 mmol/L,Scr 104 μmol/L,and blood cystatin C 1.05 mg/L 6 days later and then blood urea 5.9 mmol/L,Scr 101 μmol/L,and blood cystatin C 1.00 mg 2 months later.

A 58-year-old male patient received aspirin enteric-coated tablets 200 mg and rosuvastatin calcium 10 mg once daily by mouth,IV infusions of butylphthalide and sodium chloride injection 100 ml (containing butylphthalide 25 mg and sodium chloride 0.9 g)twice daily and troxorutin brain protein hydrolysate 10 ml once daily for acute ischemic stroke. Seven days later,laboratory tests showed blood urea 6.9 mmol/L,serum creatinine (Scr)131 μmol/L,and blood cystatin C 1.54 mg/L. Kidney injury induced by butylphthalide and sodium chloride injection was considered. Butylphthalide and sodium chloride injection was stopped but the other drugs as well as Xueshuantong for injection (注射用血栓通)and Corbrin capsule (百令胶囊)were given. Laboratory tests showed blood urea 6.2 mmol/L,Scr 104 μmol/L,and blood cystatin C 1.05 mg/L 6 days later and then blood urea 5.9 mmol/L,Scr 101 μmol/L,and blood cystatin C 1.00 mg 2 months later.

Objective To explore the needs of clinical nursing manager leadership skills, so as to provide a reference for the training and promotion. Methods Semi-structured interview was adopted in 15 nursing managers in 4 Jinan level three class A hospitals, and data were analyzed by Colaizzi′s phenomenological procedures. Results Four aspects were exacted for leadership skills: leadership power skills, management skills, professional skills, personal qualities. Conclusions The requirement of clinical nursing manager leadership skills is necessary and urgent, mainly concentrated on the management skills. The management skills should be strengthened, and pay attention to the power of leadership, professional skills and personal qualities at the same time, in order to adapt to the management requirements, and improve the quality of nursing management.